HomeMy WebLinkAboutPermit Mechanical 1993-9-14
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
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ASSESSORS MAP:
. ...... -
LOT
OWNER:
ADDRESS:
CITY'
DESCRIBE WORK'
.
SPRINGFIELD
.
JOB NUMBER
9 311/1
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I
225 Fifth Street
Springfield. Oregon 97477
TAX LOT:
9'/ fr7J
BLOCI"
STATE:
ae
SUBDIVISION'
PHONE: -.!LI./ to -1::1 C 1
ZIP: _9 74/17
NEW REMODEL ADDITION DEMOLISH OTHER
CONST,
CONTRACTOR'S NAME ADDRESS CONTRACTOR' EXPIRES PHONE
GENERA' '
PLUMBING'
MECHANICAl' &,M. '!J/LM, LIdo '1 4;.~ 905'7,s- ...z/.1' .1 3#--W.sr-
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ELECTRICAl'
ti-P
- OFFICE USE -
QUAD AREA' LAND US'" FLOOD PLAIN'
. OF BLDGS:_ . OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR, TYPE: . OF BDRMS'
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGE: SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. All Inspections requested before 7:00 a.m. will be
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
o
Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumbingl Electrical!
Mechanical - Prior to cover.
o
Footing - After trenches are
excavated.
o
Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o
Underlloor Plumbing/Mechanical
_ Prior to insulation or decking.
o
Post and Beam - Prior to floor
insulation or decking.
o Floor Insulation - Prior to
decking.
o
Sanitary Sewer - Prior to filling
trench.
o
Storm Sower - Prior to filling
trench.
o Water Line - Prior to filling
trench. .
o
Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
~ough Mechanical - Prior to
~ver.
'V1 Rough Electrical - Prior to
~or.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o
Fireplace - Prior to facing
materials and framing Insp.
o
Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After installation.
o Insert - After firepla-::e approval
and Installation ot unit.
o
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation is complete, forms
and sub.base material In place.
o Fence - When completed.
D Street Trees - When all required
trees are planted.
o Final Plumbing - When all
plumbing work Is complet,e.
~ Final Electrical - When all
~ctrlcal work is complete.
f':YFinal Mechanical - When all
I ....echanical work Is complete.
o
Final Building - When all
required inspectlo[ls have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set,Up - When all
blocking Is complete,
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set.up. and plumbing
inspections have been approved
and the home is connected to
the service panel.
o
Final - After all required
inspections are approved and
porches, skirting, decks. and
venting have been Installed.
Lot faces
.
Lot Type
Lot sq, flg,
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul,de,sac
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT,
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
'SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer FT.
Water FT,
Storm Sewer FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
WOOd Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
. THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
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IN
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Setbacks
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APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is grllnled on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee.
Date Paid:
Receipt Number.
Received By:
Plans Reviewed By
Dale
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
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By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
Information hereon Is true and correct, and I further certify
that any and all work performed shall be done in accordance
with the Ordjnanc~s of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify 1I1at only contractors and employees who
are in compliance with GRS 701.055 will be used on this
project.
I furtt1er agree to ensure that all required Inspections are
requested at the proper time, that each address is readable
from the slreet, that the permit card Is located at the front
of the property, and the approved set of plans will remain
on the site at all timos dU~ construction.
Signature Uuu--c\A/nJz1L.
Datp
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VALIDATION:
RECEIPT NUMBER
/A2s/
9 -/4 -~3
2,)." 7r
.~~<.,
DATE PAID
AMOUNT RECEIVED
RECEIVED BY